Stretcher

“ As the stretcher approached the foot of the stair two of our number stepped forth from the rank, each taking a handle from a Bluebottle; the stretcher thus proceeded on its course up the stair carried by four men, one on each handle—two Bluebottles and two R.A.M.C.'s.
That flight of iron stairs from the platform to the road seemed no very arduous ordeal for the first half-dozen journeys. There was a knack about keeping the stretcher horizontal: the front bearers must hold their handles as low as possible; the rear bearers must hoist their handles shoulder-high. ”

“ As to the use of the stretcher-straps. Many coaches imagine that when they have said, "Do not pull yourself forward by your toes against the straps," they have exhausted all that is to be said on the matter. ”

“ We asked the man if he could help himself at all as he was huge, and there is always great difficulty lifting patients off of the stretchers because there is so little space between the beds and the two carriers can’t do much more than hold the stretcher at the bed level. ”

“ This done, cut two spines, or connecting rods of bamboo, each thirty inches long and as nearly alike as possible. Next, with waxed thread, or light wire, bind the two spines over the ends of the eleven-inch stretchers. The spine must fit like the top of a letter T over the stretchers and be square; that is, at right angles with the stretcher. Each end of the spine must project beyond the uprights five and one- half inches; that is, the ends must each be five and one-half inches long, which leaves nineteen inches between points named. Bind the other four stretchers to the ends of the sticks. ”

“ We shall take six stretchers with us; the ladies will be utterly worn out after the fatigues of such a terrible day, and possibly one or all of them will need to be carried. At any rate, we shall want stretchers in case any are wounded; we must not allow any one to fall alive into the hands of these bloodthirsty scoundrels. ”

“ They may be said to be current, like money, and whenever one organization turns over a grave case to the succeeding organization, the stretcher goes with the case, and an empty one is received in return. The number at any one point is thus maintained at a constant figure, and there is a general tendency for battered and infected stretchers to gravitate toward the south of France, and for new stretchers to gravitate toward the front. ”

“ Indeed, if these movements are properly performed, you get a very pretty play of the toes and the ball of the foot against the stretcher, you counteract the tendency of the body to tumble forward, and you materially help the beginning from that part of the foot in which the spring resides. ”

“ It is usually hard to find withes that are long and straight enough to bend so as to form a good shaped stretcher. You should always aim to stretch and cure the furs you catch in the best manner. In skinning you should rip the animal straight from one heel across to the other and close to the roots of the tail on the under side. ”

“ DOWN the corridor, walking carefully, came four hospital attendants, holding the stretcher resting on two large wheels, rolling noiselessly. The operation was over. On the stretcher lay a young woman, unconscious. ”

“ Then all four splints are drawn together and held in place by rubber-plaster straps or strips of strong muslin applied as follows: one above the ankle; one below the knee; one above the knee; one in the middle of the thigh, and one around the upper part of the thigh. A wide band of strong muslin or sheeting should then be bound around the whole body between the armpits and hips, inclosing the upper part of the outside splint. The patient can then be borne comfortably upon a stretcher made of boards and a mattress or some improvised cushion. ”

“ The stretchers should be set horizontally by nailing a strip of wood, say 1 × 1Â1⁄2 × 12 inches, with a piece at each end to form a space between it and the wall, or place of location in line with the edge of the shaft, as in Fig. 48. The top of this stretcher should [Pg 50] be low enough to clear the largest pulley, and high enough to clear the hat of your tallest man. You would perhaps find it convenient to go between the spokes of a large pulley. ”

“ These stretchers require that the skin of the animal should not be ripped through the belly, but should be stripped off whole. Peel the skin from the body by drawing it over itself, leaving the fur inward. In this condition the skin should be drawn on to the split board (with the back on one side and the belly on the other) , to its utmost length, and fastened with tacks, and then the wedge should be driven between the two halves. Finally, make all fast by a tack at the root of the tail, and another on the opposite side. ”

“ In using the board stretchers the fur should always be on the inside, and when the hoop or bow is used it should be placed in such a position, that the air may circulate freely on both sides of the skin, which should not be removed until thoroughly dry. ”

“ These are underground, too, and are little better than the posts in the trenches. But they can handle more men here and do emergency work, like amputating, if necessary. Besides, when a big attack is on, blessés are brought in much faster than we can remove them and they take care of them here for a few hours, and sometimes for days if necessary. Our work is to load up the ambulances with the assistance of the brancardiers (stretcher-bearers) and carry them back to an evacuation hospital ten or twelve miles behind the lines. These are rather crude affairs and seldom employ any women nurses. ”

“ A more powerful method is by stretching the limb upon a board having axles at both ends with thongs fastened to them, by turning which such powerful extension could be made as would be sufficient even to break the muscles and tendons. When these are stretched, if the bone is dislocated [504] forwards, some round body is to be placed in the groin, and the knee is to be suddenly carried over it, for the same reason and in the same manner as in dislocations at the shoulder. In the other cases the surgeon is directed to push the bone towards its place, while an assistant propels the hip-joint. ”

“ The flexor muscles on account of the position in sitting and because of a lack of expansive activity, often become too short. They can be extended only by activity of the extensor muscles. The stretch is the special and instinctive action of the extensor muscles in response to a distinctive demand for freedom of the organs, or harmony of the whole myological mechanism. It is also, as has been said, closely connected with the circulation, and the activity of the vital organs.
There is no more important exercise than stretching. Its neglect is one of the strange things in training. ”

“ The legs, especially the thighs, are long. The foot is long and strong, and rests its lower surface, not merely the outer margin as in apes, on the ground. The elastic arch of the instep must be excepted in the above description, and adds lightness and swiftness to his otherwise slow gait. The great toe is short and generally [93] not opposable. The muscles of the leg are heavy and the knee-joint has a very broad articulating surface. But the great result of man's erect posture is that the hand is set free from the work of locomotion, and has become a delicate tactile and tool-using organ. ”

“ By the word stretchings I mean the stretching of his body and limbs by a slow and gentle convulsion of the extensor muscles; for in all the attacks I never observed the flexores any way affected. — His feelings were frequently so odd that, he said, he could not describe them. He often felt as if his left side, from his head to his waste was empty, and that millions of small bodies were drove up and down with great velocity: which he likened to the shaking of peas in a bladder. ”

“ Much trained skill and dexterity, especially in knee and arm staking, are required in the stretching, which is the essential feature of these operations. Breaking is first resorted to. The break beam, which is armed at each end with a knife edge, oscillates up and down. In a frame beneath it the operator stretches the dried and stiff skin. The break beam comes down upon the skin, stretches and softens it, and removes much surplus custard. The operator presents a new surface to each stroke of the break beam, and in a very short space of time the entire skin is rendered soft and pliable. ”

“ It is a brief extension of the limb at the knee-joint, due to a simple contraction of the extensor muscle, elicited by a tap or other short mechanical stimulus applied to the muscle fibres through the tendon of the muscle. The jerk is obtainable only from muscle fibres possessed of neural tonus. If the sensory nerves of the extensor muscle be severed, the “jerk” is lost. The brevity of the interval between the tap on the knee and the beginning of the resultant contraction of the muscle seems such as to exclude the possibility of reflex development. ”

“ Then point the toes down and stretch upper leg muscles; relax; then stretch under leg muscles by stretching heel out. The patient will feel the exercise as far as the shoulders, and should be careful not to lift the body from the floor at first. When patient can hold stretching exercise for a minute then lift first the right, then the left leg, and take same exercise until the person can give a quick little kick for, say, twelve times, as the leg is straightened. ”

“ Passing to the lower extremity, the thigh muscles are the largest and the most powerful in the body. In front a great, four-headed muscle, quadriceps extensor, unites into a single tendon in which the knee-cap is set, and serves to straighten the knee, or when rising from a sitting posture helps elevate the body. On the back of the thigh are several large muscles which bend the knee, and whose tendons, known as the “hamstrings,” are readily felt just behind the knee. On the back of the leg the most important muscles, forming what is known as the calf, are the gastrocnemius and the soleus. ”

“ In applying extension to the thigh, for example, the bands should be fastened at the ankle and above the knee, these stretching in the same direction, another band to be passed by the loins, and around the armpits, and by the perineum and thigh, one end passing up the breast and the other along the back, these all stretching in the same direction and being fastened either to a piece of wood resembling a pestle or to an axle. ”

“ I thought that if I went through a course of exercises stretching my ligaments and tendons it would also conduce to health and strength. Growing tall ought to be healthy, all right, I thought. So I got the apparatus—a fiendish-looking thing, composed of ropes, straps, buckles, and pulleys—and I set it up in an unused shed. I had taken exercises with it a few days and liked it first-rate. One evening, about dusk, I went out to take my usual “turn” and had just put on a head-gear suspended from a rope. This by a sort of hanging act was to develop and elongate the muscles of the neck. ”

“ It has long been known that a contracted muscle can be stretched to a given extent by a smaller weight than is required to stretch it when it is at rest and not contracted. This has led physiologists to say that by contraction the elasticity of the muscle is diminished in amount while it is still perfect; that is to say, a contracted muscle is easily stretched, and when the stretching force is removed, it returns at once to its former length. ”

“ The yielding of the arch lengthens the foot and puts the tendons of all the flexors on the stretch. All of them have a tendency to bend the toes, and as this action is constant, gradually the tendons of the extensors become over-stretched and these muscles are not capable of exerting their full force in overcoming the action of the flexors. The flexor longus digitorum has a tendency to cause a bending of the small toes, and as it also runs across the foot it pulls the toes somewhat inward, that is, toward the big toe. This crowding leads to hammer toes and over-riding. ”

“ Thus by flexion or dorsiflexion is meant that movement which approximates the dorsum of the foot to the front of the leg; while extension or plantar flexion means the drawing up of the heel so that the toes are pointed. In inversion the medial edge of the foot is drawn up so that the sole looks towards the middle line of the body, an attitude which is analogous to supination of the hand. In eversion the lateral edge of the foot is drawn up, the sole looking away from the middle line—analogous to pronation of the hand. ”

“ Stretch′er, anything used for stretching, as gloves, hats, &c.: a frame on which a painter's canvas is stretched by means of wedges forced into the corners: a frame for carrying the sick or dead: a footboard for a rower; Stretch′er-bond, a method of building in which bricks or stones are laid lengthwise in successive courses, the joints of the one falling at the middle of that above and below; Stretch′ing-course, a course of bricks or stones having all the faces outward ”

“ After even this brief sketch of our internal organism we are enabled better to appreciate the injury done by tight-lacing.
To begin from the outside, tight stays hinder the action of the skin of the parts they press upon by impeding the circulation; they weaken the muscles of these parts, especially those of the back, by preventing the amount of movement necessary to their healthy development. They act very much like splints, and we all know how weak the muscles feel after these have been removed. ”

“ Stretching of the muscles antagonistic to the extensors—namely, of the flexor muscles—reduces the jerk by inhibiting the extensor spinal nerve cells through the nervous impulses generated by the tense flexor muscles. Hence a favourable posture of the limb for eliciting the jerk is one ensuring relaxation of the hamstring muscles, as when the leg has been crossed upon the other. ”

“ I believe that a large number of the cases of curvature of the spine met with in surgical practice, generally in girls between the ages of twelve and sixteen, result directly or indirectly from the weight and improper pressure of clothes, a potent agent in causing the deformity being the wearing of high-heeled boots, which throw the body forward in walking. Tight, stiff stays are responsible for a great deal of harm, and I am afraid that horrible process called tight-lacing begins but too frequently earlier than is generally suspected. ”